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Large pharmaceutical companies deliberately and purposefully sow doubts about the effectiveness of generics, even though it has been confirmed both officially by the market regulator and practically by doctors who prescribe these drugs. As experts recently stated, in fact, large pharmaceutical companies intimidate consumers, forcing them to buy more expensive drugs. A trip to the pharmacy can significantly empty your wallet. Of course, you shouldn’t save on your health, but there are proven cheap analogues that are not inferior in therapeutic effect.
Such drugs are also supported by the fact that large pharmaceutical companies deliberately and deliberately try to sow doubt about their effectiveness. Meanwhile, this effectiveness has been confirmed both officially (by the market regulator) and practically - by doctors prescribing these drugs. In fact, large pharmaceutical companies are intimidating consumers into buying more expensive drugs. We have compiled a list of 16 analogues of expensive drugs - their effectiveness has been tested, including through our personal experience.
Required Items
Dressing
What you need to have:
- cotton wool, sterile bandage, gauze pads, which may be needed to apply a bandage for wounds, cuts and bruises;
- plasters – medical for fixing the bandage and bactericidal for applying to abrasions and cuts;
- elastic bandage – for fixing a limb during sprains and dislocations.
Before treating the wound and applying a bandage, be sure to disinfect your hands with an antiseptic solution (such as chlorhexedine).
Medical devices
Increases in temperature and jumps in A/D also occur in healthy people. Therefore, a thermometer and tonometer should be included in the list of necessary items for the first aid kit.
What it is
A generic, or, in official language, a “reproduced drug” is a copy of an already existing and used drug, the active component of which was developed by another pharmaceutical company. The generic should have the same effect on the body as the original medicine. They are allowed to be produced only when the patent for the original drug has already expired.
As a rule, generic drugs are cheaper than original drugs. And this is logical, because companies producing generic drugs do not spend money on developing the drug, but take a ready-made formula of the active component, tested in clinical trials and in practice.
According to the order of the Ministry of Health dated January 14, 2022 No. 4n, a doctor who prescribes a medicine does not have the right to indicate in the prescription the trade name of the drug under which it is sold in a pharmacy. He is obliged to enter the international nonproprietary name (INN) of the drug in the form - that is, the name of the active substance. Based on the INN, the pharmacy can sell both the original drug and the generic to the patient.
What is the difference
The active component of a generic drug must be the same as that of the original drug. The difference lies in the nuances of production and the composition of auxiliary active ingredients. They are added to the main drug, which weighs within a few grams, to make the medicine more convenient to dose - that is, to turn the active component into convenient tablets or injection solutions packaged in ampoules.
In theory, replacing some excipients with others should not affect the effectiveness of the medicine. But in practice it happens differently.
“Unfortunately, not all generics are of decent quality,” says internist, clinical pharmacologist at GMS Clinic Yuri Meshcheryakov. “In cardiology, for example, in the case of antihypertensive therapy, the difference between the generic and the original drug is immediately visible, since the generic often has no effect.”
Russian requirements for testing the quality of generics are much softer than the requirements established by the World Health Organization (WHO), and which are followed in the United States and the European Union. The point is in the peculiarities of the legislation.
Article 38 of the Federal Law “On the Circulation of Medicines” dated April 12, 2010 N 61-FZ states: “In relation to generic medicinal products for medical use, bioequivalence and (or therapeutic equivalence) studies are carried out in the manner established by the authorized federal executive body.”
According to the law, a study of the bioequivalence of a drug determines the rate of absorption and excretion of active substances and the amount of the drug entering the blood. In conclusion, the study authors write whether the INN of the original drug matches the INN of the generic, and whether their dosages are the same. A generic drug should act on the body in the same way as the original drug, but no one checks this during the bioequivalence study.
But according to WHO requirements, the manufacturer of a generic drug is required to prove both bioequivalence and the fact that the new drug acts on the body in the same way as the original. In fact, he is required to re-conduct a significant part of the drug's clinical trials - testing on volunteer patients. This ensures that excipients will not affect the effectiveness of the new drug and that the generic drug will work the same as the original drug.
“I always make an appendix to the prescription for the patient,” adds Meshcheryakov, “I indicate a list of good generics from the RLS commercial directory. They can be distinguished by a high Vyshkowski index, an indicator that reflects the information demand for medicines. Such generics are close in quality to the original.”
The issue of replacing expensive drugs with cheap analogues
The article discusses the issue of replacing expensive drugs with cheap analogues; critical assessments are given using the example of one (the most widespread in social networks) table. The author of the article is a practicing physician with experience in pharmacies. Recently, on the Internet, on social networks, they increasingly began to send me posts with pictures showing a comparison of expensive drugs and their cheap analogues. And I would like to express my opinion on this issue.
Firstly, I, as a person with a higher medical education, who has worked for more than a year in a pharmacy chain and actively communicates in medical circles, can see with the naked eye that such tables are not compiled by doctors. Why did I decide this? Because it is not always the most expensive drugs that are presented as expensive (namely, the most expensive ones are original), but rather those that are well-known among the mass consumer. Thus, this is clearly demonstrated by the drug Enap - the original and most expensive drug from MSD has the trade name Renitec.
Secondly, it is obvious that such tables are filled out impulsively and thoughtlessly. Taking a closer look at the table, you will notice that there are three pairs of omeprazole drugs. The left column shows a pair of Losek Maps - Omez (the price of Omez is 177 rubles), then there are drugs omez-omeprazole, where the price of Omez is already 180 rubles, and a pair of Ultop-Omez. The same goes in the neuromultivit section (relatively cheap when compared with milgamma or, especially, berocca), where pentovit comes in pairs. In general, wouldn’t it be easier to put up the most expensive and the most budget option? Also unexpectedly, towards the end of the table, fluconazole “fell in price” from 40 to 20 rubles. I don't see the logic.
Thirdly, although it is indicated in this table that the prices are given for the same doses and release forms, it is not said what these forms are, and in other tables they clearly do not think about such a trifle as the difference between the injection form and the tablet form. The same applies to quantity. For the life of me, I did not find neuromultivit in the same quantitative release form as pentovit. Neuromultivit in my city comes with 20 tablets, while Pentovit only sells 50. It’s a mystery which packages were compared in the table. And okay, here there is an increase in the price effect towards an expensive drug, but why not have a downside? I have not analyzed absolutely all versions of tables with all medications, but I am more than sure that such cases also occur.
Fourthly, it is completely unclear where prices come from. Some drugs, in my opinion, are definitely overpriced, while others are underpriced. This table concerns mezim (300 rubles – what is this pack or dosage?). And where is the pharmacy where Cavinton cost 580 rubles (well, I can still understand this, Cavinton Forte with an increased dose, large package), and Vinpocetine as much as 200?
But, in fact, it was not the logic of constructing such tables that hurt me most of all, but the fact itself. For some reason, it is believed that the effectiveness of different drugs will be the same. That a company that invented a chemical form and developed a drug, spending billions of dollars on research, is no different from a company that bought a ready-made form and produces its own drug. What are the qualities of the primary raw materials? What is the degree of purification? What is the safety profile? What is the effectiveness of the drug? The answer to this question, unfortunately, is not in favor of cheap analogues.
And the table clearly shows the drugs finlepsin and carbamazepine. I evaluate their effectiveness almost every day. The effectiveness of domestic carbamazepine in the treatment of epilepsy is especially sad. It's just almost gone.
I saw the same thing when using the drug flucanazole in the hematology department, where I was lucky enough to work as a nurse, albeit for only six months. Fungal complications (including even sepsis), which often accompanied chemotherapy for acute leukemia, developed much less frequently in patients who took “their” Diflucan prophylactically. Whereas those who received “our” fluconazole for 5 kopecks... I will remain silent. It is sad when the state saves its money in medical institutions.
Of course, there are means whose effectiveness is almost identical. Regarding neurological drugs, these are definitely B vitamins, some nootropic drugs, etc. However, this is not always the case. And, summarizing the above to the readers of the site and my patients, to whom I gave a link to the article, I would like to convey one thing. Remember, your health depends only on you. And only you can decide whether to spend financial resources, your time (if we take the question of exercise therapy) and any resources in general on your health. Just think again, can drugs that cost 1000 rubles and 10 kopecks really be exactly the same? Free cheese only comes in a mousetrap. And sometimes, by replacing a drug with analogues, you risk getting a very weak positive effect and a lot of side effects. It is better, before making a choice, to once again consult with a doctor, and not blindly believe in an incomprehensible wave of the fight against foreign drug manufacturing companies. To my great regret, our pharmaceutical industry is not yet a role model.
